Karolinska University Hospital

Innovation Centre at Karolinska University HospitalSweden has launched an innovative surgery program that makes use of video collaboration technology from Polycom. Using Polycom RealPresence video collaboration solutions to view live video, researchers at the Karolinska Insitutet, the medical university can now provide remote mentoring for surgeries during operations at other hospitals – potentially anywhere in the world. These live sessions serve as invaluable real-time training.

Experienced endoscopists at the Karolinska University Hospital perform more than 800 endoscopic retrograde cholangiopancreatography (ERCP) procedures annually. ERCP involves cannulation (entering) of the papilla duct and is used primarily to diagnose and treat conditions of the bile ducts and main pancreatic duct, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer.

The Karolinska Institutet accounts for over 40 percent of the medical academic research conducted in Sweden. Research from numerous studies revealed that remote mentoring from high-volume ERCP centers with high cannulation success rates (entering the desired duct) will allow local hospitals with less experience (due to a low volume of ERCP procedures) to offer similar treatments and interventions that benefit both patients and healthcare providers. The cannulation of a "virgin" papilla remains the most difficult step in ERCP and the ERCP procedure fails without selective cannulation of the desired duct. The Innovation Centre at Karolinska University has established a telemedicine development unit which designed the program as an innovative way to help improve the skills and confidence of the surgeons in the regional hospitals throughout Sweden, while providing the highest quality patient care via access to scarce expertise.

The project is currently conducted by clinical staff based at two centers in Sweden under the management of gastro surgeon Urban Arnelo, with plans to develop this further to other regional district hospitals. The Karolinska University Hospital has a team of four consultant surgeons available to observe the operating room at Visby District Hospital on the island of Gotland, by making use of the real-time video provided by Polycom’s executive desktop solution (Polycom HDX 4500). Visby District Hospital was selected for the project because it is the only hospital on the island and serves 57,000 inhabitants. The hospital carries out approximately 75 ERCP procedures annually; in around two thirds of these procedures, the examination is overseen by an experienced endoscopist from the Karolinska University Hospital over a Polycom RealPresence video link.